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The use of microcomputers, although increasingly common in the clinical laboratory, is not problem- or risk-free. Some of these problems and risks are discussed in this article and suggestions for minimizing them are offered. Forewarned is forearmed. The author hopes that pointing out the risks and deficiencies of microcomputers will promote their intelligent application in the clinical laboratory.
Microcomputers are invading every aspect of life including the practice of pathology. This second in a series of articles is designed to help neophytes make effective use of these new tools. A list of references, providing readers with more information on the subject of microcomputers and their applications to pathology, will be furnished at the conclusion of the series.
Microcomputers have emerged as a truly valuable tool for business, largely due to the development of high-quality software. This article discusses the most logical methods of selecting a microcomputer system and certain points to keep in mind when doing so.
The author describes the structure of a comprehensive microcomputer-based microbiology and epidemiology system as implemented in a 150-bed community hospital. The article illustrates how the program provides more efficient, cost-effective, clinically relevant microbiology laboratory reports to clinicians. The author hopes the following discussion will lessen the reluctance of small laboratories to introduce microcomputers into the laboratory.
The process outlined in this paper points to the fact that fitness assessment and exercise prescription is largely an information management task. The gap between existing knowledge and its practical application to the care of patients can be successfully closed by using modern information services. For health professionals, moving into the computer age will be an evolutionary, continuing education process. For clinical practice to reach its full potential, there must be an improvement in methods of handling information. The microcomputer offers an innovative way of providing the clinician with a practical, inexpensive manner of information management that will lead to improved efficiency, safety, and lower health care cost and at the same time provide patient satisfaction. Microcomputer applications in fitness assessment, dietary analysis and exercise prescription for the elderly are presented.
The use of a microcomputer in a small-hospital pharmacy is discussed. In a 50-bed hospital, computerization of repetitive functions was achieved with a modest expense. This was done with standard and inexpensive programs and self-written software that ran on a microcomputer purchased for the pharmacy. Time savings were immediately produced, and other uses followed to allow better use of personnel. Brief descriptions of major types of software are also given. An inexpensive computer can be used to great advantage, even in very small hospitals and without expensive pharmacy-specific software.
Use of microcomputer programs for management engineering in hospitals reduces the chore of operational planning at very low cost. This article describes some management information systems available for microcomputers and provides an example run-through to show how one such system can be used to schedule patients for surgery.
This article describes a model for a clinical nursing research program in a community hospital, some of the support roles that microcomputers can play in such a program, and some example studies conducted by nurse researchers with use of microcomputers.
The growth of microcomputer usage in health care has brought new challenges to managing them. Strategies include establishing a centralized review policy, setting up an information center staffed by a PC coordinator, and possibly implementing a local area network. Regardless of the strategy, microcomputers should be an integral part of the hospital information system and plan.
Small hospital pharmacies often are faced with staff and budgetary constraints to the point that provision of some clinical and management services is not feasible. Low cost and recent microcomputer hardware and software advances designed to facilitate and support these services have made microsystems practical and within reach of even the smallest facility. The implementation of one microcomputer pharmacy management and support system is discussed.
In the highly competitive healthcare arena, microcomputer maps illustrating everything from population shifts to sources of patient referrals are becoming important planning and marketing tools. Mapping can help facilities focus their marketing on the physician community in general or on particular physicians who may refer patients for specialized care. It can locate patients by type, physician, and other data; it can be used to illustrate requests for state approval of expansions and acquisitions; and it can help organizations target certain areas for changes in service delivery, marketing, or physician placement. Five basic components are needed to create microcomputer maps: a computer with graphics capabilities; an output device such as a printer or plotter; a data file; a boundary file; and mapping software.
IBM PC, XT, AT compatible computers have created a small revolution in the way we work, pharmacy procedures notwithstanding. In many instances the microcomputer software packages used are expensive and often difficult for inexperienced users to learn within reasonable periods of time. Public domain software, or shareware concept of software distribution, is an alternate means of obtaining good quality programs that are free to PC users, or cost very little upon final registration. This article describes a high efficiency, easy to use data management system that can serve a great variety of purposes within the pharmacy including tasks such as adverse drug reaction tracking, patient profiles, or inventory control. The flexibility and ease of operation makes this and other similar programs often wise choices as compared to expensive, fully relational commerical microcomputer data management systems.
A brief background on the status of microcomputer-based health education programs is presented. Within the current context, the authors propose a series of 13 questions arranged in hierarchical fashion to evaluate microcomputer-based health education. The value of this approach is that technically flawed programs can be screened out and important health education concerns can be integrated into an evaluation of software.
A data acquisition system employing a low power 8 bit microcomputer has been developed for heart rate variability monitoring before, during and after bathing. The system consists of three integral chest electrodes, two temperature sensors, an instrumentation amplifier, a low power 8-bit single chip microcomputer (SMC) and a 4 MB compact flash memory (CFM). The ECG from the electrodes is converted to an 8-bit digital format at a 1 ms rate by an A/D converter in the SMC. Both signals from the body and ambient temperature sensors are converted to an 8-bit digital format every 1 second. These data are stored by the CFM. The system is powered by a rechargeable 3.6 V lithium battery. The 4 x 11 x 1 cm system is encapsulated in epoxy and silicone, yielding a total volume of 44 cc. The weight is 100 g.
A respiratory and activity recording system has been developed for monitoring health conditions and living patterns, such as activity/rest time periods and general activity level. The system employs a piezoelectric sensor, a low-power operational amplifier, a low-power 8-bit microcomputer and a 512 KB EEPROM. The piezoelectric sensor, whose electrical polarization voltage is produced by mechanical strain, records body movements produced by respiration, heart pulse, walking and running. The high and low frequency components from the recorded body movements are discriminated by high and low pass filters. The high frequency components reflect the body movements produced by cardiac vibrations, walking and running activities. The low frequency components are mainly generated by respiration. The degree of activity is obtained by summing the high frequency components for 1 second. The microcomputer stores the obtained low frequency components and activity to the EEPROM at 0.2 second and 1 second intervals, respectively. After recording, these stored data are downloaded to a desktop computer. The computer then detects behavior patterns from the activity data and respiration from the low frequency components.
The authors describe a data retrieval system called REDATAM, Retrieval of Data for Small Area by Microcomputer. "The interactive REDATAM system, in English and Spanish versions, was created to solve the problem of providing small-area population and housing information by using an IBM or fully compatible microcomputer to store the microdata of an entire census on a hard disk (or laser disks for larger countries) and to permit any tabulation to be produced rapidly for any area down to city blocks or smaller....REDATAM may play an important role in the 1990 censuses in the Latin American and Caribbean countries since the system will permit the provision of timely small-area services (and at the national level in the Caribbean countries) before, as well as after, the regular data processing and publication of results are ready."
This article introduces an integrated medical diagnostic X-ray unit controlled by microcomputer. It is a practical and low-priced spot-film radiography device, and it is applicable to conventional local control unit. If you select a set of X-rayimage intensification, it can be remotely controlled. This device utilizes DC servo motor and fine precision feedback variable resistor and closed loop control so it has the advantage of fine static control and low mechanical noise. The whole radiographic process is automatically controlled by microcomputer, and can be operated easily.
A new safety and life support system has been developed to detect emergency situations of solitary-living elderly persons. The system employs a dual axis accelerometer, two low-power active filters, a low-power 8-bit single chip microcomputer and a personal handy phone. Body movements due to walking, running and posture changes are detected by the dual axis accelerometer and sent to the microcomputer. If the patient is in an inactive state for 5 minutes after falling, or for 64 minutes without previously falling, then the system automatically alarms the emergency situation, via the personal handy phone, to the patient's family, the fire station or the hospital.